Catheter placing instrument
A catheter placing instrument is provided. The catheter placing instrument includes an elongated body that extends in a longitudinal direction from a proximal end to a distal end. The elongated body has a top surface configured to receive a catheter extending from the proximal end to the distal end. The elongated body includes a catheter insertion section and a grip section. The catheter insertion section includes a catheter locking clamp located at the distal end of the elongated body, and the grip section includes a catheter guide. The catheter placing instrument can be used to place or implant any tubular medical device within a patient's body. A method of placing a tubular medical device at a deep location within a patient's body is also provided.
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The subject matter of the present invention relates generally to an instrument for placing a catheter in deep anatomical areas of the human body where visualization may be difficult.
BACKGROUNDCatheters are used in many clinical settings as devices for delivering fluid, treating an obstructed body cavity, draining fluid, and otherwise providing accesses to deep locations within the human body. While catheters of various types are highly useful, proper placement of a catheter is often a difficult procedure which can often require the insertion of a catheter, e.g., by blunt dissection during open surgery, to a blind location not visible to a surgeon, doctor, or other clinical professional. Blunt dissection involves the careful separation of tissues along tissue planes by either fingers or blunt instrument(s), without slicing through tissues using sharp or heat-actuated devices.
For example, fluid delivery catheters are often used as part of a catheter-based infusion system to both block the nerve bundles for a surgery or after a trauma, and to provide a continuous, low flow rate of the anesthetic over a period of time (e.g., 2-5 days following surgery) for post-operative pain management. In one example procedure, total knee arthroplasty, a fluid delivery catheter is inserted from an open surgical wound site blindly into the adductor canal at a distance of about 10-20 cm using a generic elongated surgical tool. Most often, this procedure is performed using a pituitary ronguer by holding a distal tip of the catheter in the alligator jaws at the distal end of the tool and bluntly dissecting the deep tissue to access the delivery site of the catheter. However, pituitary ronguers are designed for use to remove spinal bone or disc tissue and are not optimized for catheter placement.
Furthermore, existing surgical tools for catheter placement at deep locations do not provide any indication of the depth of insertion of the catheter, thus requiring surgeons to blindly approximate or estimate the depth at which a catheter has been placed.
Consequently, there is a need for a catheter placing instrument that is optimized for blind insertion into deep anatomical areas. In particular, a catheter placing instrument that provides an indication of the depth of the catheter placement at a deep anatomical area would also be useful.
SUMMARYThe present invention provides a catheter placing instrument. The catheter placing instrument includes an elongated body, the elongated body extending in a longitudinal direction from a proximal end to a distal end, the elongated body having a top surface configured to receive a catheter extending from the proximal end to the distal end. The elongated body includes a catheter insertion section and a grip section. The catheter insertion section includes a catheter locking clamp located at the distal end of the elongated body. The grip section includes a catheter guide.
In one particular embodiment, the grip section can further include a locking mechanism, wherein the locking mechanism is configured to lock and unlock the catheter locking clamp. Further, the locking mechanism can include an actuator positioned on the grip section.
In another embodiment, the catheter placing instrument can further include measurement markings extending from the distal end of the elongated body along at least one side wall of the catheter insertion section such that, when a catheter is positioned on the top surface, the measurement markings are viewable on the side wall.
In an additional embodiment, the catheter guide can include at least two protrusions extending vertically above the top surface.
In one more embodiment, the catheter locking clamp can include at least two clamp arms configured to lock a catheter in place against the top surface of the elongated body.
In yet another embodiment, the catheter insertion section has a height H1 in a vertical direction that is shorter than a height H2 of the grip section in the vertical direction.
In still another embodiment, the catheter insertion section has a width W1 in a transverse direction, and the grip section has a width W2 in the transverse direction. Further, the width W2 of the grip section can be larger than the width W1 of the catheter insertion section.
In an additional embodiment, the grip section can include a grip handle.
In a further embodiment, the top surface can be flat.
In one more embodiment, the top surface can include a concave curvature configured to hold a catheter.
In a further embodiment, the catheter placing instrument can be configured to place a catheter at a deep anatomical site of a patient.
In yet another embodiment, the catheter placing instrument can be configured to place an electrical lead having one or more electrical contacts at a deep anatomical site of a patient.
The present invention also provides a method of surgically placing a tubular medical device at a deep anatomical site of a patient. The method includes steps of: inserting a tubular medical device into an open surgical site; providing a placing instrument. The placing instrument includes: an elongated body, the elongated body extending in a longitudinal direction from a proximal end to a distal end, the elongated body having a top surface configured to receive a tubular medical device extending from the proximal end to the distal end, wherein the elongated body comprises a device insertion section and a grip section; wherein the tubular medical device insertion section comprises a locking clamp located at the distal end of the elongated body; and wherein the grip section comprises a tubular medical device guide. The method includes additional steps of: placing the tubular medical device on the top surface of the placing instrument such that a distal tip of the tubular medical device is positioned at the distal end of the elongated body and the tubular medical device extends through the tubular medical device guide; locking the tubular medical device to the placing instrument by clamping the distal tip of the tubular medical device with the locking clamp; advancing the distal end of the placing instrument into a deep anatomical location accessed by the open surgical site; releasing the release mechanism to unlock the tubular medical device from the placing instrument; and removing the placing instrument from the deep anatomical location without moving the tubular medical device.
In one particular embodiment of the method, the tubular medical device can be a catheter.
In another embodiment, the tubular medical device can be an electrical lead having at least one electrical contact.
In an additional embodiment, the placing instrument can further include measurement markings extending from the distal end of the elongated body along the longitudinal length of the tubular medical device insertion section; wherein the step of advancing includes advancing the distal end of the tubular medical device to the anatomical location to a desired depth utilizing the measurement markings to determine the depth.
In yet another embodiment, the step of advancing can include blindly advancing the distal end of the placing instrument into a deep anatomical location by blunt dissection.
In still another embodiment, the tubular medical device includes a viewable indicator. Moreover, the step of removing the placing instrument from the anatomical location without moving the tubular medical device can include visualizing the viewable indicator to ensure that the tubular medical device is not moved when the placing instrument is removed from the anatomical location.
These and other features, aspects, and advantages of the present invention will become better understood with reference to the following description and appended claims. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description, serve to explain the principles of the invention.
A full and enabling disclosure of the present invention, including the best mode thereof, directed to one of ordinary skill in the art, is set forth in the specification, which makes reference to the appended figures, in which:
Reference now will be made in detail to embodiments of the invention, one or more examples of which are illustrated in the drawings. Each example is provided by way of explanation of the invention, not limitation of the invention. In fact, it will be apparent to those skilled in the art that various modifications and variations can be made in the present invention without departing from the scope or spirit of the invention. For instance, features illustrated or described as part of one embodiment can be used with another embodiment to yield a still further embodiment. Thus, it is intended that the present invention covers such modifications and variations as come within the scope of the appended claims and their equivalents.
As used herein, the terms “about,” “approximately,” or “generally,” when used to modify a value, indicates that the value can be raised or lowered by 5% and remain within the disclosed embodiment.
To assist in the description of the system and method of use disclosed herein, the following terms are used. The “wound site” is the area within the body of the patient where the surgical procedure was performed. The “incision site” is the area where the surgeon entered through the patient's skin to arrive at the wound site. The incision site need not be made by the surgeon, for example, a patient may have an open wound through which the surgeon arrives at the wound site. The “pierce site” is the site where the patient's skin is pierced to allow the catheter to extend therethrough and arrive at the wound site. The term “distal” refers to a site that is away from a specified site. The term “proximal” refers to a site that is close to a specified site. Expressed alternatively, a site termed “proximal” is measurably closer to a specified reference point than a site termed “distal.”
Generally speaking, the present invention is directed to a catheter placing instrument having an elongated body that extends in a longitudinal direction from a proximal end to a distal end. The elongated body has a top surface configured to receive a catheter extending from the proximal end to the distal end. The elongated body includes a catheter insertion section and a grip section. The catheter insertion section includes a catheter locking clamp located at the distal end of the elongated body, and the grip section includes a catheter guide. The catheter placing instrument can be used to place a catheter, an electrical lead, or any other tubular medical device at a deep anatomical location of a patient. Specific features of the catheter placing instrument of the present invention may be better understood with reference to
Referring now to
As best illustrated in
As shown in
As shown in
The length L of the shaft 111 is configured to be at least as long as a perfusion segment of a catheter. For example, the shaft 111 can have a length L in a range from about 1 inch to about 20 inches, such as from about 2 inches to about 15 inches, or from about 4 inches to about 10 inches.
The grip section 120 can form a handle 122, illustrated in
As shown in
The grip section 120 of the catheter placing instrument 100 may also be made of a polymer, metal, or other material or combination of materials, e.g., a polymer and a metal. The grip section 120 and the catheter insertion section 110 may, in some instances, be constructed of the same material or combination of materials. For example, the elongate body 102 can be formed of a single, unitary piece of material, such as a rigid polymer or metal. In other instances, the grip section 120 and the catheter insertion section 110 can be formed of separate components that are attached together to form the elongate body 102, e.g., via a two-piece construction. For example, grip section 120 may be made of polymer and catheter insertion section 110 may be made of metal and attached to the grip section 120 to form the elongate body 102, or alternatively, the grip section 120 can be made of metal and the catheter insertion section 110 can be made of polymer. Example metals or alloys from which grip section 120 or catheter insertion section 110 may be constructed include, but are not limited to, stainless steel, titanium, titanium alloys, nickel-cobalt, and nickel-cobalt alloys. Example polymers may include, but are not limited to, acetal resin, polyether ether ketone (PEEK), polycarbonate, polypropylene composites, and liquid-crystal polymer (LCP). In some instances, elongated body 102 may be a single, unitary piece of material. In other embodiments, grip section 102 may be removable (not shown).
Further, the distal end 105 of the shaft 111 of the elongated body 102 may be shaped to aid in tunneling through tissue or muscle. For example, the distal end 105 may be tapered, angled, blunt, rounded, pointed, bent, or otherwise shaped to enable a user to perform blunt dissection through subcutaneous tissue without excess damage to surrounding tissue, piercing through the skin, or coring of the tissue.
Still referring to
The locking and unlocking of the catheter locking clamp 130 can be controlled by a locking mechanism 150. The locking mechanism 150 can have an actuator 152 to initiate the locking or unlocking of the clamp 130. The actuator 152 can preferably be located on the grip section 120 of the catheter placing instrument 100 for convenient access by a user holding the grip section 120. The actuator 152 can be in the form of any suitable mechanism for initiating the unlocking (opening) and locking (closing) of the catheter locking clamp 130. For example, as illustrated in
As shown in
As shown in
Similarly,
Other possible embodiments of the actuator for the release mechanism include a retractable push-button actuator, either positioned on one of the sides of the grip section 120 or on a proximal end of the catheter placing instrument 100 similar to a retractable pen, or any other quick-release mechanism.
In one possible embodiment, illustrated in
In a total knee arthroplasty procedure, the catheter 10 can be inserted intraoperatively into the medial intermuscular septum to provide a continuous adductor canal and periarticular nerve block. The catheter insertion can occur during a medial parapatellar, midvastus, or subvastus approach to the TKA. The medial parapatellar procedure can be performed by incising the vastus medialis oblique muscle beginning medially just above the patella and extending down to the tibial tubercle, leaving a cuff of capsular tissue on the patella for repair at closure. For the mid-vastus approach, the vastus medialis oblique muscle is split in-line with the muscle fibers at the superior pole of the patella and then incised distally to the tibial tubercle. The subvastus approach to TKA begins with an incision below the vastus medialis oblique muscle and extends to the tibial tubercle.
After the surgical approach to the knee, described above, the adductor tubercle of the epicondyle of the femur is identified. Then, the vastus medialis oblique muscle is elevated with blunt retractors to expose its deep surface and the anterior surface of the medial intermuscular septum. The medial intermuscular septum can then serve as the floor for the placement of the catheter 10. The adductor magnus tendon can be palpated beneath the medial intermuscular septum just cephalad (in the direction of the patient's head) to the adductor tubercle. The vastus medialis oblique muscle and the adductor magnus muscle form the borders of the adductor canal. As defined above, the open surgical site is considered to be the wound site for placement of the catheter 10.
In step 602, the catheter 10 can be inserted into the open surgical wound site by any conventional procedure. For example, an introducer needle can be positioned within a T-peel sheath and inserted through a piercing site near the open surgical wound site and advanced into the wound site, the introducer needle removed, and the catheter 10 then advanced through the T-peel sheath into the open wound site. The catheter 10 can be retrieved from the T-peel sheath by grasping the distal end 12 of the catheter 10 to advance the catheter 10 through the sheath.
After advancing a length of the catheter 10 through the T-peel sheath to at least expose a length of the catheter 10 within the wound site as long as the length of the elongated body 102 of the catheter placing instrument 100, the catheter 10 can be loaded onto the catheter placing instrument 100 in step 604. First, a user ensures that the actuator 152 is released so that the catheter locking clamp 130 is unlocked. Then, the distal tip 12 of the catheter 10 is positioned in the catheter locking clamp 130 on the top surface 104 of the catheter placing instrument 100, and the catheter 10 is positioned so that it rests on the top surface 104 of the instrument 100 from the distal end 105 to the proximal end 106 and extends through the catheter guide 134 at the proximal end of the top surface 104. Then, a user can lock the catheter locking clamp 130 around the distal tip 12 of the catheter 10 to lock the catheter 10 in place. The step of locking the catheter locking clamp 130 can be performed by actuating the actuator 152, e.g., by sliding the actuator 152 of
Next, in step 606, the user grasps the handle 122 of grip section 120 of the catheter placing instrument 100 and inserts the distal end 105 of the instrument 100 into the wound site and then advances the distal end 105 of the instrument cephalad along the anterior surface of the medial intermuscular septum and deep to the vastus medialis oblique muscle, e.g., about 15-20 cm cephalad to the superior patella, within the adductor canal. In step 608, the user visualizes the depth of insertion of the distal end 105 of the instrument 100 and the distal tip 12 of the catheter 10 by the measurement markings 112 on the side of the shaft 111, as shown in
It is to be understood that the above method is non-limiting and that the catheter placing instrument of the present invention can be used in methods of catheter insertion during other surgical procedures. Additionally, the catheter placing instrument of the present invention can be used for the implantation, insertion and/or placement of any other elongated member or device into the human body.
This written description uses examples to disclose the invention, including the best mode, and also to enable any person skilled in the art to practice the invention, including making and using any devices or systems and performing any incorporated methods. The patentable scope of the invention is defined by the claims and may include other examples that occur to those skilled in the art. Such other examples are intended to be within the scope of the claims if they include structural elements that do not differ from the literal language of the claims or if they include equivalent structural elements with insubstantial differences from the literal language of the claims.
Claims
1. A catheter placing instrument comprising:
- an elongated body, the elongated body extending in a longitudinal direction from a proximal end to a distal end, the elongated body having a top surface configured to receive a catheter extending from the proximal end to the distal end, wherein the elongated body comprises a catheter insertion section and a grip section, further wherein the catheter insertion section comprises a shaft extending from the distal end of the body to the grip section of the body, wherein the shaft is formed by the top surface, a first side surface, a second side surface and a bottom surface, further wherein the top surface forms an uppermost surface of the shaft;
- wherein the catheter insertion section comprises a catheter locking clamp located at the distal end of the shaft and extending vertically above the shaft; and
- wherein the grip section comprises a catheter guide.
2. The catheter placing instrument of claim 1, wherein the grip section further comprises a locking mechanism, wherein the locking mechanism is configured to lock and unlock the catheter locking clamp.
3. The catheter placing instrument of claim 2, wherein the locking mechanism comprises an actuator positioned on the grip section.
4. The catheter placing instrument of claim 1, further comprising measurement markings extending from the distal end of the elongated body along the first side wall and/or the second side wall of the catheter insertion section such that, when the catheter is positioned on the top surface, the measurement markings are viewable.
5. The catheter placing instrument of claim 1, wherein the catheter guide comprises at least two protrusions extending vertically above the top surface.
6. The catheter placing instrument of claim 1, wherein the catheter locking clamp comprises at least two clamp arms configured to lock the catheter in place against the top surface of the elongated body.
7. The catheter placing instrument of claim 1, wherein the catheter insertion section has a height (H1) in a vertical direction that is shorter than a height (H2) of the grip section in the vertical direction.
8. The catheter placing instrument of claim 1, wherein the catheter insertion section has a width (W1) in a transverse direction, and the grip section has a width (W2) in the transverse direction.
9. The catheter placing instrument of claim 8, wherein the width (W2) of the grip section is larger than the width (W1) of the catheter insertion section.
10. The catheter placing instrument of claim 1, wherein the grip section comprises a grip handle.
11. The catheter placing instrument of claim 1, wherein the top surface is flat.
12. The catheter placing instrument of claim 1, wherein the top surface comprises a concave curvature configured to hold the catheter.
13. The catheter placing instrument of claim 1, wherein the catheter placing instrument is configured to place the catheter at a deep anatomical site of a patient.
14. The catheter placing instrument of claim 1, wherein the catheter placing instrument is configured to place an electrical lead having one or more electrical contacts at a deep anatomical site of a patient.
15. A method of surgically placing a tubular medical device at a deep anatomical site of a patient, the method comprising steps of:
- inserting a tubular medical device into an open surgical site;
- providing a placing instrument, the placing instrument comprising: an elongated body, the elongated body extending in a longitudinal direction from a proximal end to a distal end, the elongated body having a top surface configured to receive the tubular medical device extending from the proximal end to the distal end, wherein the elongated body comprises a tubular medical device insertion section and a grip section; wherein the tubular medical device insertion section comprises a shaft extending from the distal end of the elongated body to the grip section of the body, wherein the shaft is formed by the top surface, a first side surface, a second side surface and a bottom surface, and a locking clamp located at the distal end of the shaft; and wherein the grip section comprises a tubular medical device guide;
- placing the tubular medical device on the top surface of the placing instrument such that a distal tip of the tubular medical device is positioned at the distal end of the shaft and the tubular medical device extends through the tubular medical device guide;
- locking the tubular medical device to the placing instrument by clamping the distal tip of the tubular medical device with the locking clamp;
- advancing the distal end of the placing instrument into a deep anatomical site accessed by the open surgical site;
- releasing a release mechanism to unlock the tubular medical device from the placing instrument; and
- removing the placing instrument from the deep anatomical site without moving the tubular medical device.
16. The method of claim 15, wherein the tubular medical device is a catheter.
17. The method of claim 15, wherein the tubular medical device is an electrical lead having at least one electrical contact.
18. The method of claim 15, wherein the placing instrument further comprises measurement markings extending from the distal end of the elongated body along the longitudinal length of the shaft;
- wherein the step of advancing includes advancing the distal end of the tubular medical device to the anatomical site to a desired depth utilizing the measurement markings to determine the depth.
19. The method of claim 15, wherein the step of advancing includes blindly advancing the distal end of the placing instrument into the deep anatomical site by blunt dissection.
20. The method of claim 15, wherein the tubular medical device includes a viewable indicator;
- further wherein the step of removing the placing instrument from the anatomical site without moving the tubular medical device comprises visualizing the viewable indicator to ensure that the tubular medical device is not moved when the placing instrument is removed from the anatomical site.
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Type: Grant
Filed: Feb 27, 2019
Date of Patent: Jun 21, 2022
Patent Publication Number: 20200268413
Assignee: Avent, Inc. (Alpharetta, GA)
Inventors: Steve S. Khalaj (Laguna Hills, CA), Eric A. Schepis (Alpharetta, GA), Thomas D. Mina (Newport Beach, CA)
Primary Examiner: Tan-Uyen T Ho
Assistant Examiner: Rachel S Highland
Application Number: 16/286,769
International Classification: A61B 17/34 (20060101); A61N 1/05 (20060101); A61M 25/02 (20060101); A61M 25/01 (20060101); A61M 25/00 (20060101); A61M 25/09 (20060101);